Tracing Of Foodborne IllnessesFalls Under A Patchwork Of Poorly-run, Under-resourced State Labs

Jim Prevor’s Perishable Pundit, April 22, 2009

We’ve been writing about it for years, but finally The New York Times has picked up on the food safety problem caused by incompetent and under-resourced state labs. Gardiner Harris wrote a piece titled, Ill From Food? Investigations Vary By State:

In just about every major contaminated food scare, Minnesotans become sick by the dozens while few people in Kentucky and other states are counted among the ill.

Contaminated peanuts? Forty-two Minnesotans were reported sick compared with three Kentuckians. Jalapeno peppers last year? Thirty-one in Minnesota and two in Kentucky became ill. The different numbers arise because health officials in Kentucky and many other states fail to investigate many complaints of food-related sickness while those in Minnesota do so diligently, safeguarding not only Minnesotans but much of the rest of the country, as well.

In fact what state one is in can make a big difference in the way an individual experiences the government reaction to a foodborne illness:

Take the case of Lauren Threlkeld, who went to a Kroger grocery store in Lexington, Ky., in August 2007 and bought a bag of Dole baby spinach contaminated with E. coli O157. She became violently ill with bloody diarrhea and was hospitalized for nearly a week.

When Ms. Threlkeld finally went home to recuperate in Madisonville, Ky., a county health worker called only to verify that she had fallen ill in another county. No one asked about the foods she had eaten or what might have made her so ill, she said. Later efforts by her lawyer pinpointed the source of her illness — far too late to help others avoid similar fates.

Dr. William D. Hacker, the public health commissioner in Kentucky, blamed tight budgets. “We have had a historically poor record of reporting” food-borne illnesses, Dr. Hacker said. “We are working hard to change our culture even with limited resources.”

In Minnesota and a few other states, victims of food-related illnesses tell very different stories. Sarah Kirchner of Belle Plaine, Minn., said health workers called her three separate times and spent hours discussing her children’sdiet almost immediately after a laboratory test verified that one had fallen ill with salmonella. Officials in Minnesota traced the outbreak to peanut butter in part because of Ms. Kirchner’s responses.

Many states are very limited in terms of laboratory capacity:

In Utah, for instance, only 18 of the state’s 1,388 medical laboratories process stool tests, said Dr. Pat Luedtke, director of the Utah public health laboratory.

There also are other barriers to gathering the needed information:

Well-meaning doctors who wish to send stool samples sometimes must pay the postage because insurers often refuse to pay for a test that largely serves a public health function; many doctors do not bother.

This New York Times reporter caught this key insight:

Congress and the Obama administration have said that more inspections and new food production rules are needed to prevent food-related diseases, but far less attention has been paid to fixing the fractured system by which officials detect and stop ongoing outbreaks. Right now, uncovering which foods have been contaminated is left to a patchwork of more than 3,000 federal, state and local health departments that are, for the most part, poorly financed, poorly trained and disconnected, officials said.

The truth is that hiring inspectors to stand around plants in the hope they will see invisible pathogens is an enormous waste of money. In contrast, bringing every state lab and public health service up to the level of Minnesota would be a wise and transformational investment in food safety.